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6/14/12blog post

whoo whoo whooping cough!

Ethan had his one year old check up – can you believe he is 1 already? He has really started changing from my baby into a little toddler. He is walking (and falling down) everywhere now and has even started climbing. His favorite word to use is “no!”

Anyway, I digress!

While at his pediatrician’s office I was asked if Jeff and I had obtained our whooping cough vaccine booster. I was pleasantly surprised by this question. Being what I consider to be an open minded advocate for immunizations I was pleased that this important vaccine was being addressed to us, his parents. You see, whooping cough is still a pretty common illness in our country even in spite of the vaccine series routinely being given to our children. And although whooping cough most often only causes an annoying, lingering cough in adolescents and adults, it can cause severe illness and even death in our very young and elderly.

Whooping cough, aka pertussis, aka the 100 day cough, is caused by the Bordetella pertussis bacteria. This infection affects the lungs, causing swelling and inflammation in the linings of the airways. A person who becomes infected may have cold like symptoms for a few days (I know- not very helpful symptoms). They will develop a cough that is often described as a staccato cough (rapid, short bursts). This cough is often so severe that people have difficulty catching their breath and they will make a “whooping” noise in between bursts of coughing (hence the name “whooping cough”.) The coughing can be quite severe and may cause vomiting and even petechiae (small breakings of blood vessels that can cause red dots on the skin that do not fade or blanch if you touch them.)

The infection can cause more severe problems in the very young. They often struggle to eat, drink, and even breathe. I have seen firsthand the devastation that this illness can cause and have spent sleepless nights monitoring the breathing of infants and young children affected by pertussis. The infection can even lead to pneumonia, seizures, brain damage, and death. Before the vaccine was developed in the 1940’s, there were reportedly between 150,000 and 200,000 cases of whooping cough every year. With the vaccine this number has been reduced to about 10,000 to 30,000 cases every year.

However, we have realized that the effectiveness of the vaccine wanes over time and therefore we are in need of booster dosing after childhood. Currently the CDC recommends that adolescents receive a pertussis booster (combined with tetanus= Tdap) at age 11 years old or prior to entering 7th grade. It is also highly encouraged and recommended that all adults receive the same booster dose of Tdap once, especially if they will be in close contacts with babies and small children. It is believed that by protecting all persons around an infant from a serious illness, we will be able to protect the infant and their budding immune systems; this is known as cocooning.

The infants should also receive the series of vaccines with pertussis in them (DTaP) at 2 months, 4 months, 6 months, 12-18 months, and 4-6 years, but they are not fully protected until they have completed the series.

Obviously there are risks as well as benefits to all immunizations. This risk of problems from receiving the vaccine must be weighed against the risk of contracting the infection or worse, infecting a small child with pertussis. Please just consider the vaccine for you and your household, discuss it with your healthcare provider. Your local health department may be able to provide the vaccine for free or at reduced cost should you need assistance.

Stay healthy!